In this thesis several studies are presented that have targeted decision making about case management plans in probation. In a case management plan probation officers describe the goals and interventions that should help offenders stop reoffending, and the specific measures necessary to reduce acute risks of recidivism and harm. Such a plan is embedded in a judicial framework, a sanction or advice about the sanction in which these interventions and measures should be executed. The topic of this thesis is the use of structured decision support, and the question is if this can improve decision making about case management plans in probation and subsequently improve the effectiveness of offender supervision. In this chapter we first sketch why structured decision making was introduced in the Dutch probation services. Next we describe the instrument for risk and needs assessment as well as the procedure to develop case management plans that are used by the Dutch probation services and that are investigated in this thesis. Then we describe the setting of the studies and the research questions, and we conclude with an overview of this thesis.
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Presentatie gegeven over de review in Brussel Objectives: In the past decades many psychosocial interventions for elderly people with dementia have been developed and implemented. Relatively little research has been done on the extent to which these interventions were implemented in the daily care. The aim of this study was to obtain insight into strategies for successful implementation of psychosocial interventions in the daily residential dementia care. Using a modified RE-AIM framework, the indicators that are considered important for effective and sustainable implementation were defined.
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A dominant concern with internationalisation through the past decades has been the process of strategic transformation of universities. While strategic management has been perceived as a necessary and useful approach in the construction of internationalisation, many criticisms have been levelled against the application of strategic management in internationalisation. One of these criticisms is the ‘implementation gap’ between internationalisation strategic plans and their actual outcomes. Based on interview data collected from 73 key actors involved in internationalisation at 16 Dutch public universities, this research identifies 12 elements that comprise the concept strategic management and illustrates how educational practitioners in different sectors (research universities and universities of applied sciences) and job function levels (central and faculty) prioritise these elements. The key contribution of this research is the clarification of the areas where the ‘implementation gap’ exists and the causes of this gap. The findings of this research are particularly important in the midst of uncontested popularisation of strategic management, because they can help universities to reduce this gap and improve the effectiveness of their strategic management practices.
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Background: The number of people suffering from one or more chronic conditions is rising, resulting in an increase in patients with complex health care demands. Interprofessional collaboration and the use of shared care plans support the management of complex health care demands of patients with chronic illnesses. This study aims to get an overview of the scientific literature on developing interprofessional shared care plans. Methods: We conducted a scoping review of the scientific literature regarding the development of interprofessional shared care plans. A systematic database search resulted in 45 articles being included, 5 of which were empirical studies concentrating purely on the care plan. Findings were synthesised using directed content analysis. Results: This review revealed three themes. The first theme was the format of the shared care plan, with the following elements: patient’s current state; goals and concerns; actions and interventions; and evaluation. The second theme concerned the development of shared care plans, and can be categorised as interpersonal, organisational and patient-related factors. The third theme covered tools, whose main function is to support professionals in sharing patient information without personal contact. Such tools relate to documentation of and communication about patient information. Conclusion: Care plan development is not a free-standing concept, but should be seen as the result of an underlying process of interprofessional collaboration between team members, including the patient. To integrate the patients’ perspectives into the care plans, their needs and values need careful consideration. This review indicates a need for new empirical studies examining the development and use of shared care plans and evaluating their effects.
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For the integrated implementation of Business Process Management and supporting information systems many methods are available. Most of these methods, however, apply a one-size fits all approach and do not take into account the specific situation of the organization in which an information system is to be implemented. These situational factors, however, strongly determine the success of any implementation project. In this paper a method is provided that establishes situational factors of and their influence on implementation methods. The provided method enables a more successful implementation project, because the project team can create a more suitable implementation method for business process management system implementation projects.
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Aims and objectives: To describe the process of implementing evidence-based practice (EBP) in a clinical nursing setting. Background: EBP has become a major issue in nursing, it is insufficiently integrated in daily practice and its implementation is complex. Design: Participatory action research. Method: The main participants were nurses working in a lung unit of a rural hospital. A multi-method process of data collection was used during the observing, reflecting, planning and acting phases. Data were continuously gathered during a 24-month period from 2010 to 2012, and analysed using an interpretive constant comparative approach. Patients were consulted to incorporate their perspective. Results: A best-practice mode of working was prevalent on the ward. The main barriers to the implementation of EBP were that nurses had little knowledge of EBP and a rather negative attitude towards it, and that their English reading proficiency was poor. The main facilitators were that nurses wanted to deliver high-quality care and were enthusiastic and open to innovation. Implementation strategies included a tailored interactive outreach training and the development and implementation of an evidence-based discharge protocol. The academic model of EBP was adapted. Nurses worked according to the EBP discharge protocol but barely recorded their activities. Nurses favourably evaluated the participatory action research process. Conclusions: Action research provides an opportunity to empower nurses and to tailor EBP to the practice context. Applying and implementing EBP is difficult for front-line nurses with limited EBP competencies. Relevance to clinical practice: Adaptation of the academic model of EBP to a more pragmatic approach seems necessary to introduce EBP into clinical practice. The use of scientific evidence can be facilitated by using pre-appraised evidence. For clinical practice, it seems relevant to integrate scientific evidence with clinical expertise and patient values in nurses’ clinical decision making at the individual patient level.
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Background Interprofessional education is promoted as a means of enhancing future collaborative practice in healthcare. We developed a learning activity in which undergraduate medical, nursing and allied healthcare students practice interprofessional collaboration during a student-led interprofessional team meeting. Design and delivery During their clinical rotation at a family physician’s practice, each medical student visits a frail elderly patient and prepares a care plan for the patient. At a student-led interprofessional team meeting, medical, nursing and allied healthcare students jointly review these care plans. Subsequently, participating students reflect on their interprofessional collaboration during the team meeting, both collectively and individually. Every 4 weeks, six interprofessional team meetings take place. Each team comprises 9–10 students from various healthcare professions, and meets once. To date an average of 360 medical and 360 nursing and allied healthcare students have participated in this course annually. Evaluation Students mostly reported positive experiences, including the opportunity to learn with, from and about other healthcare professions in the course of jointly reviewing care plans, and feeling collectively responsible for the care of the patients involved. Additionally, students reported a better understanding of the contextual factors at hand. The variety of patient cases, diversity of participating health professions, and the course material need improvement. Conclusion Students from participating institutions confirmed that attending a student-led interprofessional team meeting had enabled them to learn with, from and about other health professions in an active role. The use of real-life cases and the educational design contributed to the positive outcome of this interprofessional learning activity.
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The adaptation of urbanised areas to climate change is currently one of the key challenges in the domain of urban policy. The diversity of environmental determinants requires the formulation of individual plans dedicated to the most significant local issues. This article serves as a methodic proposition for the stage of retrieving data (with the PESTEL and the Delphi method), systemic diagnosis (evaluation of risk and susceptibility), prognosis (goal trees, goal intensity map) and the formulation of urban adaptation plans. The suggested solution complies with the Polish guidelines for establishing adaptation plans. The proposed methodological approach guarantees the participation of various groups of stakeholders in the process of working on urban adaptation plans, which is in accordance with the current tendencies to strengthen the role of public participation in spatial management. https://doi.org/10.12911/22998993/81658
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Background Literature on self-management innovations has studied their characteristics and position in healthcare systems. However, less attention has been paid to factors that contribute to successful implementation. This paper aims to answer the question: which factors play a role in a successful implementation of self-management health innovations? Methods We conducted a narrative review of academic literature to explore factors related to successful implementation of self-management health innovations. We further investigated the factors in a qualitative multiple case study to analyse their role in implementation success. Data were collected from nine self-management health projects in the Netherlands. Results Nine factors were found in the literature that foster the implementation of self-management health innovations: 1) involvement of end-users, 2) involvement of local and business partners, 3) involvement of stakeholders within the larger system, 4) tailoring of the innovation, 5) utilisation of multiple disciplines, 6) feedback on effectiveness, 7) availability of a feasible business model, 8) adaption to organisational changes, and 9) anticipation of changes required in the healthcare system. In the case studies, on average six of these factors could be identified. Three projects achieved a successful implementation of a self-management health innovation, but only in one case were all factors present. Conclusions For successful implementation of self-management health innovation projects, the factors identified in the literature are neither necessary nor sufficient. Therefore, it might be insightful to study how successful implementation works instead of solely focusing on the factors that could be helpful in this process.
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It has become a topic at Dutch educational institutes to feel not only responsible for improvement of theoretical and practical skills, but also of 'competences' in a broader sense. The curriculum of the Electrical and Electronic (E&E) Department has been changed enormously in the past decade. Fewer lessons and many more projects were introduced. We have choosen to let the students work on competences especially in the projects they are in. With the introduction of competences and the aid of a student portfolio we have given the tools to the students to improve their competences in a broader way. At the E &E department we introduced two different ways of working on competences. In the first years of their study students choose different roles in our projects every time. We have described all the roles and the related tasks for each specific role. While working on a role, the students indirectly work on different competences. This way of working inforces a broader educational level (a student shouldn t work on things he already knows or is able to handle) and the hitch hiking behaviour is banned out. Students now do take responsibility while contributing to the project teams. Inquiries amongst the students confirm these results. The second way is working on the specific competences in their traineeship and thesis work in the last part of their study. This will be introduced in autumn 2004 in the E&E department. In this paper we will show you how we are implementing the integration of competences, like the E&E department did, for IPD projects as well. This implementation is planned to start in autumn 2004.
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